PCR-based clonality analysis: A reliable method for the diagnosis and follow-up monitoring of conservatively treated gastric B-cell MALT lymphomas?

A. Aiello, R. Giardini, C. Tondini, M. Balzarotti, T. Diss, H. Peng, D. Delia, S. Pilotti

Research output: Contribution to journalArticle

Abstract

Aims: We evaluated polymerase chain reaction (PCR) amplification of specific immunoglobulin heavy chain (IgH) gene rearrangements as a means of demonstrating monoclonality during follow-up of conservatively treated gastric MALT lymphoma, and compared the reproducibility of PCR on sequential frozen and paraffin-embedded endoscopic biopsies. We established an association between clonality detected by PCR and the histological observations. Methods and results: Sixty-nine pairs of sequential frozen and paraffin-embedded endoscopic biopsies from 21 conservatively treated patients were graded according to the Wotherspoon-Isaacson histological scoring system, which provides a measure of diagnostic confidence on a scale 0-5. PCR amplification of the IgH gene was performed using FR3/JH and FR2/JH primers. 68/69 paired samples (98.5%) showed identical mono- or polyclonal PCR amplification patterns. Forty-seven out of 48 pairs of samples sharing similar histological features produced identical amplification patterns in both fresh and paraffin-embedded tissues. In comparison with the histological grading, monoclonality was detected in 64.2% and 41.6% of samples scored 5 and 4, respectively. Conversely, among 64 samples scored 0-3, a monoclonal pattern was observed only in two samples, one of which was from a patient who relapsed 9 months later. Conclusions: PCR-based clonality analysis by demonstration of specific IgH gene rearrangement can be easily and reliably performed on both frozen and paraffin-embedded endoscopic biopsies. In conjunction with histological observation, this method can be used as a complementary tool to monitor MALT lymphoma regression during conservative treatment.

Original languageEnglish
Pages (from-to)326-330
Number of pages5
JournalHistopathology
Volume34
Issue number4
DOIs
Publication statusPublished - 1999

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Marginal Zone B-Cell Lymphoma
B-Cell Lymphoma
Stomach
Immunoglobulin Heavy Chain Genes
Paraffin
Polymerase Chain Reaction
Gene Rearrangement
Biopsy
Observation

Keywords

  • Clonality analysis
  • MALT lymphoma
  • Polymerase chain reaction

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Cell Biology

Cite this

PCR-based clonality analysis : A reliable method for the diagnosis and follow-up monitoring of conservatively treated gastric B-cell MALT lymphomas? / Aiello, A.; Giardini, R.; Tondini, C.; Balzarotti, M.; Diss, T.; Peng, H.; Delia, D.; Pilotti, S.

In: Histopathology, Vol. 34, No. 4, 1999, p. 326-330.

Research output: Contribution to journalArticle

Aiello, A. ; Giardini, R. ; Tondini, C. ; Balzarotti, M. ; Diss, T. ; Peng, H. ; Delia, D. ; Pilotti, S. / PCR-based clonality analysis : A reliable method for the diagnosis and follow-up monitoring of conservatively treated gastric B-cell MALT lymphomas?. In: Histopathology. 1999 ; Vol. 34, No. 4. pp. 326-330.
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N2 - Aims: We evaluated polymerase chain reaction (PCR) amplification of specific immunoglobulin heavy chain (IgH) gene rearrangements as a means of demonstrating monoclonality during follow-up of conservatively treated gastric MALT lymphoma, and compared the reproducibility of PCR on sequential frozen and paraffin-embedded endoscopic biopsies. We established an association between clonality detected by PCR and the histological observations. Methods and results: Sixty-nine pairs of sequential frozen and paraffin-embedded endoscopic biopsies from 21 conservatively treated patients were graded according to the Wotherspoon-Isaacson histological scoring system, which provides a measure of diagnostic confidence on a scale 0-5. PCR amplification of the IgH gene was performed using FR3/JH and FR2/JH primers. 68/69 paired samples (98.5%) showed identical mono- or polyclonal PCR amplification patterns. Forty-seven out of 48 pairs of samples sharing similar histological features produced identical amplification patterns in both fresh and paraffin-embedded tissues. In comparison with the histological grading, monoclonality was detected in 64.2% and 41.6% of samples scored 5 and 4, respectively. Conversely, among 64 samples scored 0-3, a monoclonal pattern was observed only in two samples, one of which was from a patient who relapsed 9 months later. Conclusions: PCR-based clonality analysis by demonstration of specific IgH gene rearrangement can be easily and reliably performed on both frozen and paraffin-embedded endoscopic biopsies. In conjunction with histological observation, this method can be used as a complementary tool to monitor MALT lymphoma regression during conservative treatment.

AB - Aims: We evaluated polymerase chain reaction (PCR) amplification of specific immunoglobulin heavy chain (IgH) gene rearrangements as a means of demonstrating monoclonality during follow-up of conservatively treated gastric MALT lymphoma, and compared the reproducibility of PCR on sequential frozen and paraffin-embedded endoscopic biopsies. We established an association between clonality detected by PCR and the histological observations. Methods and results: Sixty-nine pairs of sequential frozen and paraffin-embedded endoscopic biopsies from 21 conservatively treated patients were graded according to the Wotherspoon-Isaacson histological scoring system, which provides a measure of diagnostic confidence on a scale 0-5. PCR amplification of the IgH gene was performed using FR3/JH and FR2/JH primers. 68/69 paired samples (98.5%) showed identical mono- or polyclonal PCR amplification patterns. Forty-seven out of 48 pairs of samples sharing similar histological features produced identical amplification patterns in both fresh and paraffin-embedded tissues. In comparison with the histological grading, monoclonality was detected in 64.2% and 41.6% of samples scored 5 and 4, respectively. Conversely, among 64 samples scored 0-3, a monoclonal pattern was observed only in two samples, one of which was from a patient who relapsed 9 months later. Conclusions: PCR-based clonality analysis by demonstration of specific IgH gene rearrangement can be easily and reliably performed on both frozen and paraffin-embedded endoscopic biopsies. In conjunction with histological observation, this method can be used as a complementary tool to monitor MALT lymphoma regression during conservative treatment.

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